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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 1
OCT and OCT Angiography WellnessWhy and How to Implement Early Detection
into Your Practice
Greg A. Caldwell, OD, FAAOOptometric Education Consultants
Disclosure Statement(next slide)
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Disclosures- Greg Caldwell, OD, FAAO
$ Will mention many products, instruments and companies during our discussion¬ I don’t have any financial interest in any of these products, instruments or companies
$ Pennsylvania Optometric Association –President 2010 2 POA Board of Directors 2006-2011
$ American Optometric Association, Trustee 2013-2016 $ I never used or will use my volunteer positions to further my lecturing career$ Lectured for: Aerie, Alcon, Allergan, BioTissue, OptoVue$ Advisory Board: Allergan, Maculogix, Sight Sciences, Sun, Takeda $ Envolve: PA Medical Director, Credential Committee
$ Optometric Education Consultants- Scottsdale, St. Paul, Quebec City, Nashville, and Orlando/Disney OCT Users meeting; Owner
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Resource: OCT Community for OCT and OCT-A
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Book Resources
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How Many People Here Have an OCT?
OCT, Wellness, Angiography
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 2
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P r o p r ie ta r y in fo r m a t io n o f U n i te d H e a l th G r o u p . D o n o t d is t r ib u te o r r e p r o d u c e w i th o u t e x p r e s s p e r m is s io n o f U n i te d H e a l th G r o u p .
Wellness Industry
10ry
• Global Wellness institute 2018
USAWellness
• 170b
• Optometry Industry• 65b
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Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Primary Medical Care
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• Health Institute Research 2016
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My/Our Wellness ProgramOur Transition
$Optos for over 15 years$OCT Wellness for 5 years
¬ Retina and GCC¬ Retina, GCC, angiography
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WellnessiVue®
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WellnessAngioVue® OCT
Angiography
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 3
AngioWellness
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Comments
$Where is Duncansville, PA?
$Annual income for Duncansville, PA¬ $42,500
$OCT Angiography and Widefield Imaging¬ Enhances patient care¬ Elevates the practice
2 Patient point of view2 Medical community
¬ Additional benefits to the office
2Cash flow2 Stability
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Optometry’s Instrument2018 with 2.8 Full Time Equivalent
Wellness $ 2355 scans
$Optos/Optovue Wellness¬ 1315, $50, $65,750
$Optos/Optovue Wellness and Retina OCT-A¬ 984, $70, $68,880
$OCT-A ¬ 37, $35, $1,295
$OCT-Wellness¬ 19, $35, $665
$$136,590¬ $48,782
Medical OCTs$ 765 scans $ Glaucoma
¬ 92133 406¬ Approx $37, $15,022
$ Retina¬ 92134 356¬ Approx $40, $14,240
$ Anterior Segment¬ 92132 3*¬ Approx $31, $93
$ $29,355¬ $10,484
$165,945¬ $59,266
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A Look at Wellness
$Total wellness OCTs for 2018¬ 2355¬ 197 per month
$January 1, 2019 thru December 31, 2019¬ 2765 wellness OCTs¬ 231 per month
$Wellness for 2020 thru August 25, 2020¬ 1512
¬ June 371¬ July 239
$OCT Angiography¬ Enhances patient care¬ Elevates the practice
2 Patient point of view2 Medical community
¬ Additional benefits to the office2 Cash flow2 Stability
A Look at Wellness
$Total wellness OCTs for 2018¬ 2355¬ 197 per month
$January 1, 2019 thru December 31, 2019¬ 2765 wellness OCTs¬ 231 per month
$Wellness for 2020 thru August 25, 2020¬ 1512¬ June 371¬ July 239
$OCT Angiography¬ Enhances patient care¬ Elevates the practice
2 Patient point of view2 Medical community
¬ Additional benefits to the office2 Cash flow2 Stability
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A Nice Feature
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 4
OCT Angiography A New Approach to Protecting Vision
} Non-invasive visualization of individual layers of retinal vasculature} Pathology not obscured by fluorescein staining or pooling} Image acquisition requires less time than a dye-based procedure} Reduced patient burden allows more frequent imaging to better follow disease
progression and treatment response
OCTA of CNVFA of CNV
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Enface OCT-A SlabsBased on Retinal Anatomy
Deep Plexus (INL – OPL)
Superficial Plexus (ILM – IPL) Outer Retinal Zone (ONL – BM)
Choroid Capillaris
En Face Visualization of Layers Based on Retinal Anatomy
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Normal Retinal Vasculature
Superficial Capillary Plexus
3µm Below ILM → 15 µm Below IPL
Deep Capillary Plexus
15µm Below ILM → 70 µm Below IPL
Outer Retina
70µm Below IPL → 30 µm Below RPE Reference
Choriocapillaris
30 µm Below RPE Reference → 60 µm Below RPE Reference
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AngioWellness ReportComprehensive Eye Exam - Healthy
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 5
AngioWellness ReportPatient 1 with Diabetes
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AngioWellness ReportPatient 2 with Diabetes
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AngioWellness ReportPatient 3 with Diabetes
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AngioWellness ReportPatient 3 with Diabetes
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AngioWellness ReportGlaucoma IOPs 24 OU
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AngioWellnessAMD Patient
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 6
AngioWellnessAMD Patient
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Evaluation AMD Patients for Neovascularization
Patient 1 Early Detection
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Evaluation AMD Patients for NeovascularizationPatient 1Early Detection and Early Treatment
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Evaluation AMD Patients for NeovascularizationPatient 2 Early Detection
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Evaluation AMD Patients for NeovascularizationPatient 2 Early Detection
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$Every patient coming in for a comprehensive eye exam is offered the Wellness package
$ It all starts at the front desk at check in
$Everyone knows the script
Steps and Tools of How Our Office Offers the Wellness
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 7
“The doctor WANTS you to have the Optomap and OCT photo’s done today. When combined these photo’s capture the surface and layers of the retina which gives the doctor a complete image. During your exam the doctor will review these photos with you. Carefully read over this form, check what you would like to have done today, and sign / date the bottom”
Tips:
$Only answer questions about cost if asked
$Don’t say: “You do not have to fill this out if you don’t want any of the photos”
Our Patient Script
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WellnessImagesandOCT-AInformation
HealthcarehasmovedtoEarlyDetection
Visionthreateningdiseasessuchasglaucoma,maculardegeneration,diabeticretinopathy,orchangesfromhighbloodpressureorcholesteroloftenhavenooutwardsignsorsymptoms,soourpracticeisusingstate-of-the-arttechnologytoassessthehealthofyoureyes.Ourdoctorscandetectvisionthreateningandsystemicdiseasesintheirveryearlystages,whentheyaremosttreatable.
Optomap&WellnessOCT:OurwellnessimagesincludeboththeWellnessOCTretinalscanandOptomap.TheWellnessOCTallowsthedoctorstoviewthelayersoftheretinabelowthesurfaceimagecapturedbytheOptomap.Thedoctorwantsyoutohavethesetestsaspartofyourannualvisittoday.Thecostisonly$50.
Optomap,WellnessOCT,&OCTA-A:Ifyouaresufferingfromdiabetes,highbloodpressure,highcholesterol,rheumatologicaldisease,haveafamilyhistoryordiagnosisofage-relatedmaculardegeneration.Thedoctorwantsyoutohavethesetestsaspartofyourannualvisittoday.Inthisbundledpackage,theOCT-Aonlycostsanadditional$20,foratotalof$70.
Yes,Iacceptthefeeandwouldliketohave:
______Optomap&WellnessOCT(routineannualexam)
______Optomap,WellnessOCT,&OCT-A(annualexamforpatientswithdiabetes,highbloodpressure,cholesterol,rheumatologicaldisease,familyhistoryordiagnosisofage-relatedmaculardegeneration)
Signature:______________________________________Date:________________
Our Forms Given to Patient
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Benefits: That Our Staff Uses
$Complete image behind the eye; larger view than with the slit lamp$Quick; takes minutes at most
$Patient friendly, non-invasive, no pain or drops to acquire images
$Becomes a part of the medial record that will be compared to past images for any change and / or start a baseline for future photos¬ “Just like a driver’s license photo, you change over time without realizing it”
$Do not have to have age related disease for these photo’s to be done / beneficial
$ There are not always signs or symptoms of problems; asymptomatic
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$Expand patient care and practice revenue with OCT Angiography$Value of early detection of abnormal retinal vessels in
comprehensive eye exams¬Patients with diabetes¬Glaucoma or ocular hypertensive patients¬Macular degeneration
$How to educate staff and patients on OCT Angiography
$Using vascular imaging in the diagnosis, treatment, and management on ocular disease
Program Recap of OCT Angiography
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$I can’t say it enough$ OCT Angiography and Wellness
¬ Enhances patient care
¬ Elevates the practice
2 Patient point of view2 Medical community
¬ Additional benefits to the office
2 Cash flow2 Stability
Final Thoughts
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Billing an OCT Angiography
$Wellness$No CPT Code
$Medical$No CPT Code
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OCT Wellness - More Than Wellness September 12, 20/20
Greg A Caldwell, OD, FAAO [email protected] 814-931-2030 cell 8
A Look at Wellness
$Total wellness OCTs for 2018¬ 2355¬ 197 per month
$January 1, 2019 thru December 31, 2019¬ 2765 wellness OCTs¬ 231 per month
$Wellness for 2020 thru August 25, 2020¬ 1512
¬ June 371¬ July 239
$OCT Angiography¬ Enhances patient care¬ Elevates the practice
2 Patient point of view2 Medical community
¬ Additional benefits to the office2 Cash flow2 Stability
A Look at Wellness
$Total wellness OCTs for 2018¬ 2355¬ 197 per month
$January 1, 2019 thru December 31, 2019¬ 2765 wellness OCTs¬ 231 per month
$Wellness for 2020 thru August 25, 2020¬ 1512¬ June 371¬ July 239
$OCT Angiography¬ Enhances patient care¬ Elevates the practice
2 Patient point of view2 Medical community
¬ Additional benefits to the office2 Cash flow2 Stability
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Resource: OCT Community for OCT and OCT-A
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Book Resources
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Thank-Youand
Hope You Enjoyed
Greg Caldwell, OD, [email protected]
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